The effectiveness and acceptability of a traffic light labelled menu with energy information to signpost customers towards healthier alternatives in a table service restaurant

Abstract

Background: An increase in energy dense meals eaten outside the home has been identified as a contributing factor in the rise in obesity over the last 25 years (WHO, 2003). Initiatives that clearly signpost healthier restaurant meal choices that are lower in energy and fat may offer a valuable customer service with potentially important public health, as well as commercial, benefits. The aim of this study was to investigate whether a traffic light labelled menu with healthier choices for two main courses was an acceptable and effective means of encouraging healthier food choices in a table service restaurant. Methods: A menu was developed for an independent table service restaurant to offer ‘standard’ and ‘healthier’ (lower in fat and energy) alternatives for two main courses: one meat and one fish dish. Both sets of dishes were nutritionally analysed and colour coded on the menu in accordance with Food Standard's Agency traffic light signposting guidelines and energy information (FSA, 2009). Over a 2‐week period, the choice of dishes made by customers using the menu and their views about whether they liked the initiative, found it useful and whether they would use it in future were surveyed using a questionnaire given after the meal. Practical and commercial issues around preparation, analysis and cost of implementing the menu were assessed in a qualitative interview with the head chef (also the restaurant owner). Results: Seventy surveys were returned from customers [66% female, mean age 42 years (age range 16–65+ years)] over the 2‐week period. Of those ordering from the separate menu, almost half (46%) chose the healthy alternative. The concept of a healthy alternatives menu was popular, with 90% (n = 60) of customers who returned a survey stating they either did order or would consider ordering a healthy alternative when eating out. Of 24 customer comments, 25% stated they considered eating out a time to indulge. Women were more strongly in favour than men of the concept of healthy alternatives and of having nutritional information on a menu. Customers who ate out frequently were more likely to order a healthy alternative (rho = 0.249, P = 0.044). Interestingly, choosing a healthy main course increased the likelihood of ordering dessert (rho = 0.459, P = 0.000), thus potentially negating any energy and fat savings. Seventy percent (n = 39) of customers returning the survey said they would like to see healthy alternatives provided in other restaurants. Feedback from the restaurant staff suggested they were broadly in favour of the initiative as a valuable customer service but felt that analysing recipes for a rotating menu in an independent restaurant was both time consuming and costly. Discussion: A traffic light labelled menu with energy information appears to be popular and effective in signposting some customers towards healthier alternatives in a table service restaurant. The finding that the provision of this information on menus was particularly popular with women is supported by other studies (Mac...

Menu labelling and healthy food choices: a randomised controlled trial

“…Traffic light labelling is also considered a simple menu labelling format and studies have shown a positive relationship between the traffic light system and healthier food choices (Heathcote and Baic, 2011; Morley et al , 2013; Thorndike et al , 2014; Yepes, 2014). In the present study however, this was not the case, as the TLS+GDA format was not as effective as IL+S on influencing the choice of healthier foods.…”

“…The impact of providing menu labelling on food choices may differ depending on different factors, such as age, gender and weight. Young adults (18-24 years) (Dumanovsky et al , 2010; Pulos and Leng, 2010), women (Bezerra and Sichieri, 2009; Bollinger et al , 2011; Heathcote and Baic, 2011) and overweight people (Dowray et al , 2013) tend to see and use menu labelling in their food choices.…”

Preferences for menu labelling formats of young adults in Brazil and in the United Kingdom

“…Brazilians considered this information could be easy to understand and could help them make an appropriate food choice. Previous studies conducted in the United Kingdom showed the traffic light system can be effective to encourage healthy choices and can be a good menu labelling format for restaurants [8,9]. Even many British participants considered format as the second preferred menu labelling option, for some students this information is confusing, suitable only for packaged foods and unable to help them with food choices.…”

“…In the United Kingdom, the provision of menu labelling is also voluntary [7], however the discussion has been occurring for a long time and some formats, as traffic light system has been tested on menus [8,9].…”

Contextual influences on eating behaviours: heuristic processing and dietary choices

“…In this case, children were more likely to be influenced by the heart pictogram than by the calorie labels (58). However, a field study that placed traffic light labels on healthier menus showed that the labelling was acceptable to consumers, but when consumers ordered these healthy meals they were significantly more likely to order a dessert, which negated any reduction in calories from choosing the healthy meal (59).…”